New Model of Oncology Treatment

MDT (multi-disciplinaryteam) is to provide an integrated, comprehensive and patient-centered diagnostic and treatment model for tumor patients. In other words, according to the patient’s physical condition, the pathological type, invasion scope (stage) and development trend of tumor, the existing treatments are applied in a planned and rational way, in order to increase the cure rate of tumor and improve the quality of life of the patient, which can also be called multidisciplinary treatment model (MDT). It is the latest treatment model in medical industry and the future development direction of tumor treatment. In recent years, with the improvement of people’s understanding of tumor biological behavior, the treatment mode of tumor has changed from single surgery to the new treatment mode of perioperative multidisciplinary collaboration. Surgery, radiotherapy, chemotherapy, biologic combination therapy or other adjuvant therapies such as cancer prevention and dietary therapy all need to be used together to achieve effective treatment. The MDT model is different from the traditional tumor treatment model. In the traditional model, patients go to the hospital for certain clinical symptoms or signs in the course of tumor diagnosis and treatment, and after the first doctor gives certain examinations, he/she is recommended to see a tumor specialist (e.g. surgical oncology), and the specialist still needs to apply for some diagnostic examinations according to the needs of his/her specialty, so as to clarify whether there are indications for treatment in the specialty (surgery). (The specialist still needs to apply for some diagnostic tests according to the need of his specialty, so as to clarify whether there are indications for treatment in his specialty. If they do not have the indication for surgical treatment, they will be referred to other specialties (such as radiation oncology or medical oncology). This will be repeated until a suitable specialty is found, and then the patient will be given a treatment plan and receive treatment. In the meantime, there may be inconsistency of opinions among different disciplines, which makes the patient confused about the choice of treatment. The MDT model is that after the patient is diagnosed with tumor by the first doctor, the patient is recommended to the corresponding MDT specialty group (e.g. respiratory tumor group, breast tumor group, gastrointestinal tumor group, etc.) according to the patient’s disease, and the MDT performs staging examination according to the requirements of staging examination; after clarifying the patient’s pre-treatment staging, the treatment plan is formulated according to the clinical treatment guidelines or clinical research protocols, taking into account the patient’s individual situation. Doctors of different specialties in MDT are experts who have been engaged in the research of the specialty for a long time, and their research on tumor can follow the latest international research progress, and their diagnosis and treatment level is at the highest level among their peers. For patients, it means the most optimal treatment plan and the most satisfying and worry-free medical experience. The work of MDT requires the participation of all participating departments, applying the principles of evidence-based medicine to develop mutually agreed treatment guidelines and research plans for specific diseases that are in line with current research directions. There is a consultation system with a fixed time and a fixed location; there are integrated clinics and joint visits with multidisciplinary participation to determine treatment plans for specific cases. The comprehensive treatment plan is determined after the diagnosis is clear and there is a comprehensive treatment team to discuss and determine the plan, i.e., the treatment plan is predetermined before treatment, e.g., a non-small cell lung cancer case should be determined before treatment begins whether to do pre-surgical chemotherapy, or pre-surgical radiotherapy, or post-surgical radiotherapy or chemotherapy, rather than discussing whether to give radiotherapy or chemotherapy after surgery. Determine clinical treatment guidelines for specific diseases, supervise them together, and implement them strictly, aiming for all cases to be able to be applied to different clinical studies, and encourage and support participation in clinical studies. For example, if a patient has stomach discomfort, gastroscopy is performed first, and if the diagnosis of gastric cancer is clear, the previous treatment model is to consider surgery first, and if surgery is possible, radical surgery is performed, and postoperative observation and follow-up is performed; if surgery is not possible, symptomatic treatment is performed; the process of MDT is: mainly convening doctors from general surgery, chemotherapy, radiotherapy, pathology, gastrointestinal endoscopy, intervention, and imaging to make a comprehensive assessment of the patient’s preoperative disease stage, and then making a clinical diagnosis. For patients who are not suitable for surgery, the oncologists will first implement drug therapy and make a review and evaluation plan. When the tumor shrinks, surgery will be performed in time. Neoadjuvant chemotherapy will be administered, followed by surgery and postoperative adjuvant chemotherapy, and the plan will be adjusted according to the condition and followed up regularly. For patients who are suitable for surgery, surgery will be performed by surgeons first, and then the subsequent comprehensive treatment plan will be decided according to the pathological examination results, ultimately achieving the goal of prolonging patients’ survival time and maintaining their quality of life. The advantages of MDT are mainly reflected in the following aspects: firstly, the time from diagnosis to treatment is shortened after multidisciplinary consultation and discussion. Doctors from different specialties in MDT can see all the clinical diagnostic information at the same time and determine the best individualized treatment plan suitable for specific patients according to the commonly accepted treatment principles and clinical guidelines, which absorbs the opinions of all parties and is more reasonable, Secondly, the medical resources of the hospital can be fully and effectively integrated to maximize the role of various departments such as surgery, radiotherapy and chemotherapy; once again; through consultation, all departments can discuss together and complement each other’s strengths and weaknesses to maximize the correction of irregular treatment behaviors, and break the barriers of departments, and surgical and internal medicine, Western medicine and Chinese medicine, open and minimally invasive treatment methods can be organically integrated, and in the treatment process, the treatment is strictly In the treatment process, the treatment is carried out in strict accordance with the norms of cancer treatment, instead of administering treatment as a matter of course. At the same time, MDT is also a mode of continuing education, through specific case consultation and discussion, to further promote communication between different disciplines, to enhance the understanding of different disciplines, to make a more comprehensive understanding of oncology knowledge, to guarantee the implementation of the best treatment plan, to obtain a high level of medical quality and therapeutic efficacy, to facilitate the development of clinical research and basic scientific research, to accelerate the updating of knowledge and to ensure a leading position in the discipline. Doctors can obtain new knowledge from the speeches of doctors in other departments and make up for their shortcomings, so that their knowledge can be updated. Not only young doctors can gain a lot of knowledge that cannot be learned from books, but also senior doctors can gain a lot of new knowledge from other departments or fields. Moreover, MDT is good for research and medical education, and all patients who enter the comprehensive treatment group can participate in patient-centered clinical research and basic research. At present, domestic and foreign oncology treatment centers have successively adopted MDT model for standardized comprehensive treatment of tumors, including MDT for lung cancer, MDT for gastric cancer, MDT for colorectal cancer, MDT for liver cancer and so on. The multidisciplinary collaboration group of each tumor includes oncology surgery, medical oncology, radiotherapy, medical imaging, pathology, laboratory, bioimmunology and other related departments. Domestic and international studies have confirmed that the efficacy of tumor patients who have undergone multidisciplinary treatment is significantly improved and their survival period is significantly prolonged. Multidisciplinary comprehensive treatment of tumor is the most internationally respected tumor treatment mode and the most advanced comprehensive diagnosis and treatment mode of malignant tumor, which has become the mode and development direction of tumor clinical treatment at home and abroad, and is also the mode that best meets the actual treatment needs at this stage. With the overflow of multidisciplinary wave, more and more hospitals have started the exploration and attempt of multidisciplinary collaboration in clinical practice. At present, MDT has moved beyond the fields of oncology and cardiovascular care to a broader medical development space, and some domestic industry experts point out that “a patient-centered medical service model that emphasizes quality, safety, effectiveness, and timeliness” will definitely become the driving force for continuous medical improvement in this century, and the core concept of multidisciplinary collaboration (MDT) is precisely the “patient-centered medical service model”. The core concept of MDT is precisely “patient-centered”, which is the fundamental reason for the increasing wave of multidisciplinary collaboration. Some authorities in the field have also predicted that multidisciplinary collaboration is “a necessary stage to the future of medicine”. Recently, more departments in our hospital have adopted this model, which has enabled many patients to get the best treatment effect and brought into play the comprehensive strength of a general hospital. At present, the incidence rate of tumor in China is increasing year by year, and the number of advanced and advanced tumor cases is increasing, therefore, the multidisciplinary comprehensive treatment of tumor is very necessary, which will fundamentally change the status quo that tumor patients are at a loss when seeking medical treatment and doctors rely solely on their personal experience to formulate treatment plans, so that tumor patients can get more effective and more targeted individualized series of treatment, which will be discussed and debated to regulate the tumor treatment behavior, improve medical quality and guarantee medical safety. It also reflects the comprehensive level of a hospital in tumor treatment, adapts to the trend of rapid development of tumor diagnosis and treatment, integrates the advantageous resources of tumor diagnosis and treatment, and provides a platform for multidisciplinary communication and cooperation.